FIU Week 3 Family Therapy Strategic Family Treatment Plan

Strategic Treatment Plan1. For the treatment plan assignments, you do not need to cite the text. For homework and
discussions, please do. The template is a little wonky and I anticipate it would not let you
add the reference.
2. Make sure that you use clear evidence of the theory for each treatment plan. The Gehart
text has examples. I would suggest that you paraphrase examples in the text to be in your
own words. Turnitin will pick up the direct quotes if you were to use the textbook.
3. Each of your case examples or vignettes is going to include a family. Make sure to address
all family members. You don’t need to do all the intervention as the therapist, but do need
to document what you refer out or are asking parents to follow through on. For example, in
this week’s case, there are developmental and medical issues in the children that need to be
addressed, so you should include those in your plan. Make sure to represent all participants
in the case.
4. I specifically look for resources related to closing/discharge/aftercare. When you are done
providing family therapy, what else does the family need? These cases are complex enough
that all of them will need aftercare.
5. You are welcome to use the treatment plan template in the text; most students tend to do
that. If you want to recreate it in a Word document, that’s okay too. Just make sure that you
include all areas so that your version is complete.
Create a Strategic Family Treatment Plan utilizing the following case example:
A family was referred to the Parent and Child Development Center by Carin, Hannah
Holmes’ maternal Aunt, who is concerned that Hannah seems so withdrawn. Carin, who
is unable to drive, has never met Julia but recalls Jordyn and Jorge as nice children who
used to come to visit often. Carin says “maybe it is normal for Hannah to be so busy
with 3 kids now, but she calls less often and does not sound like herself when she does
call”. Hannah agreed to an initial visit by a Family Specialist Social Worker
Holmes Family:
Hiram – 45
Hannah – 44
Jorge – 5
Jordyn – 3
Julia – 18 mos.
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The Holmes family live in a suburban neighborhood outside of Lexington, KY.
Hiram works approximately 50 hours a week as a mid-level executive at an
insurance company; Hannah was trained as a dental hygienist, but has stayed at
home since the birth of Jorge; finances are somewhat strained as they bought a
huge house 3 years ago and are now having trouble making house payments.
Contemplating trying to sell and move closer to Jorge’s job downtown.
Married for 12 years.
Not active in church, though starting to look for church home for kids (come from
different backgrounds – he Jewish, she Catholic – sometimes experience conflict
on faith traditions; looking for common ground for support; tried going to different
places, did not like what they have found so far after 4 different visits “We are
pretty discouraged” – looking for support on this topic)
The family of origin: Hiram’s family of origin – he was an only child; father died
from heart disease when he was 50, as did his grandfather at 48. Mother was
emotionally somewhat absent, often volunteering rather than spending time with
Hiram, Hiram largely raised himself. Little other family connections. Hannah
comes from a large family where she is the middle of 8 children (7 girls and 1
son) – brother was the youngest and is “spoiled”, but lives near Hannah and is
helpful to the Holmes around the house – fixes things. Hannah competes with
her sisters for her parent’s attention. She does not often tell her problems to her
family for fear she will sound “needy”. Hannah is very close to an Aunt who lives
in Nebraska – they talk on the phone several times a week.
Health – Hiram is about 50 pounds overweight and very worried about family
health history, but has “no time” to work out or take walks. Hannah walked every
day with a next door neighbor and the kids but the neighbor moved away last
year just after Julia was born. Hannah finds herself having a very hard time
losing the “baby weight” and reports that she often sits around watching TV
rather than walking or cleaning. Playing with the kids is getting harder for her to
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do – “it takes too much energy”. She has felt this way since shortly after Julia
was born. She is still nursing Julia. She quit nursing Jorge and Jordyn when both
were 12 months old.
Children:
o Jorge: Active 5 year old – runs a lot, good on stairs, loves stacking blocks,
does not always take directions well. Listens very well to Hiram, but
recently has started defying Hannah. Seeks attention a lot – hides behind
mother’s legs when asked questions. Goes to preschool half-days
(afternoons) and will be in Kindergarten in the fall. Very bossy of Jordyn,
says little about Julia, has thrown blocks at Julia. Followed normal
development stages of walking and talking. Prescribed glasses at age 3.
o Jordyn: precocious 3-year old, very friendly to strangers – she sat on your
lap immediately – very attention seeking. Good motor skills and advanced
verbal skills – speaks very clearly. Brings everything to Hannah, even
before asked. Hiram describes her as a “little mother”. Caters to Julia.
Very caring. Followed normal developmental stages of walking and
talking. No major illnesses.
o Julia: 18 mo. old – not walking yet. Some crawling; poor coordination and
leg strength; shows little curiosity, babbles; can sit up without much help,
beginning to use her thumb to pick up objects, drops one object when
handed another, looks to Jordyn when she needs something, watches
Jorge a lot, but little communication. Very attached to Jordyn, not as much
to her mother or father. Father sometimes plays peekaboo, but she is not
interested unless he is touching her hands or arms, otherwise, she ignores
him. Has not been to the doctor since she was 9 months old.
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Strategic Family Treatment Plan
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Strategic Family Treatment Plan
According to Gehart (2015), the primary goal of strategic family treatment therapy entails
addressing present challenges through small changes that restructure the family interactional
sequence. In this instance, Hannah’s family is in a rut overwhelming the members, making them
disengaged from family and individual needs. The Parent and Child Development Centre
therapist can help them solve their crisis through three stages.
Initial Phase
In this phase, the therapists’ goal is to develop a working relationship with the client and
assess their cultural, individual, and systemic dynamics (Gehart, 2015). Notably, Hannah’s
agreement to an initial visit shows a willingness to work with the therapist in this instance.
Therefore, the therapist should employ common courtesy strategic positioning to build a rapport
with the family. They should kick start their engagement with an everyday conversation to make
Hannah and her family comfortable. This entails small talk such as how they are doing or
whether they had difficulties finding the place and information about themselves, their cultural
background, and family dynamics. As a result, they can let their guard down and feel
comfortable sharing with the therapist.
Once both parties establish a working relationship, the therapist will move to the problem
stage, where the family will describe their issues. In this instance, the family is experiencing
multiple issues. They have financial constraints that are making it challenging to make house
payments. Also, there are religious constraints with the parents lacking a common ground on
their preferred church for their kids due to their different religious backgrounds. In addition, both
parents have neglected their health and are overweight. The parents are also experiencing
difficulties raising their children where they seem unable to fully cater to their attention,
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emotion, and developmental needs. Once the family lists these issues, the therapist moves to the
next step.
Goal setting is the next step. As for the client, their objective in this phase is crisis
management by reducing the escalation of the most painful symptoms. According to Gehart
(2015), the client’s objective in this phase is crisis management by reducing the escalation of the
most distressing symptoms. Therefore, both parties will agree on the most pressing issues and
seek to address them. As Gehart (2015) further points out, this treatment approach addresses
problems through a set of unique directives to restructure the family interaction pattern.
Therefore, the therapist will work with the family to develop guidelines to solve these pressing
issues. Notably, these initial directives will be a crucial platform for the therapist to understand
the family’s interactional patterns.
Working Phase
In this phase, the therapist should concentrate on diagnosing the family interaction
patterns to develop interventions. Therefore, they must recommend the family to act as naturally
as possible. The therapist should create scenarios that allow the family to showcase their daily
interaction patterns. For example, if one of the parents raises a concern, the therapist can ask
them to direct to their spouse and observe their subsequent interactions over the presented issue.
Notably, this diagnostic technique is essential in helping the therapist identify maladaptive
interaction patterns in the family.
Depending on the presenting symptoms, the therapist can conceptualize and classify them
in five different ways. They include involuntary versus voluntary, helplessness versus power,
metaphorical versus literal, hierarchy versus equality, and hostility versus love (Gehart, 2015).
Additionally, the therapist must acknowledge the family’s developmental stage. In Hannah’s
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case, they are in their early parent life. In this instance, the family is struggling to grapple with
the new demands of parenthood. Therefore, it becomes crucial that the therapist helps them
reorganize their interaction to ensure that they attain proper balance. In addition, the therapist can
utilize framing to reduce the symptom’s negativity and motivation the family to change. For
example, Jorge, the firstborn child, acts bossy and hostile to Julia, the last born, and defies his
mother. As a result, Hannah, his mother, might label Jorge as a problematic child. However, the
therapist can reframe this statement and illustrate Jorge as simply a child deprived of attention
due to his busy parents. Therefore, this can motivate both parents to reorganize their patterns and
show more attention to Jorge.
Overall, the therapist and Hannah’s family shall develop structural interventions to make
strategic changes that address the symptoms. These interventions should only represent subtle
changes to the family’s interaction that significantly alter their overall pattern (Gehart, 2015).
Also, these interventions take place during therapy, and the therapist gives them homework tasks
for the family to implement collaboratively after the sessions. The therapist then assesses their
impact following implementation and whether they achieved the intended outcome. Through a
series of sessions and task directives, the family will completely overhaul their interaction
pattern to make it function better and strengthen their alliance.
In addition, during these sessions, the therapist will continue learning more about the
family. This is in aspects such as relationship dynamics and belief systems. For example, they
should pay attention to the differences in religious background and how they affect their
interaction on matters of religion. For example, Hannah is a catholic while her husband is a Jew.
Adapting to these conditions becomes crucial as it strengthens their bond with the family
(Gehart, 2015). This will then improve the quality of their working relationships and,
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subsequently, the interventions. Also, it will be crucial that the therapist exercises cultural
competence not to impose their beliefs and value system on the family. Instead, they adapt to the
family’s beliefs.
Closing Phase
By the end of the therapy program, the family shall have a new relationship pattern that
serves their needs better. Here, the therapist’s role is to reinforce this pattern. This way, they will
avoid regressing to the previous maladaptive behaviors. Once the therapist is satisfied by the
family’s level of relationship intimacy, they can end the sessions.
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References
Gehart, D. R. (2015). Theory and treatment planning in counseling and
psychotherapy (2nd Ed.). Cengage Learning.